Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship study.
Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship study.
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DOI：
10.1158/1055-9965.epi-08-0531
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发表时间：
2009-01
期刊：
影响因子：
--
通讯作者：
Yu H
中科院分区：
文献类型：
--
作者：
Irwin ML;Varma K;Alvarez-Reeves M;Cadmus L;Wiley A;Chung GG;Dipietro L;Mayne ST;Yu H
高胰岛素和IGF-I水平可能与乳腺癌风险增加和/或死亡有关。鉴于需要确定降低胰岛素、IGF-I和乳腺癌风险和死亡的可改变因素，我们研究了6个月随机对照有氧运动干预与常规护理对绝经后乳腺癌幸存者空腹胰岛素、IGF-I及其结合蛋白（IGFBP-3）的影响。75名绝经后乳腺癌幸存者来自耶鲁-纽黑文医院肿瘤登记处，并随机分配到运动组（n = 37）或常规护理组（n = 38）。运动组进行150 min/wk的中等强度有氧运动。常规护理组被指示保持其当前的体力活动水平。在基线和6个月时采集每个研究参与者的空腹血液样本。用酶联免疫吸附法测定胰岛素和IGFs的血液水平。平均而言，锻炼者增加了129分钟/周的有氧运动，而常规护理参与者为45分钟/周（p <0.001）。随机分配到运动组的妇女胰岛素、IGF-I和IGFBP-3水平降低，而随机分配到常规护理组的妇女这些激素水平升高。胰岛素、IGF-I和IGFBP-3的组间差异分别为20.7%（p = 0.089）、8.9%（p = 0.026）和7.9%（p = 0.006）。中等强度的有氧运动，如快走，降低IGF-I和IGFBP-3。运动引起的IGFs减少可能介导了较高水平的体力活动与乳腺癌患者生存率提高之间的相关性。
High insulin and IGF-I levels may be associated with an increased breast cancer risk and/or death. Given the need to identify modifiable factors that decrease insulin, IGF-I, and breast cancer risk and death, we investigated the effects of a 6-month randomized controlled aerobic exercise intervention vs. usual care on fasting insulin, IGF-I and its binding protein (IGFBP-3) in postmenopausal breast cancer survivors. Seventy-five postmenopausal breast cancer survivors were identified from the Yale-New Haven Hospital Tumor Registry and randomly assigned to an exercise (n = 37) or usual care (n = 38) group. The exercise group participated in 150 min/wk of moderate-intensity aerobic exercise. The usual care group was instructed to maintain their current physical activity level. A fasting blood sample was collected on each study participant at baseline and 6 months. Blood levels of insulin and IGFs were measured with enzyme-linked immunosorbent assays. On average, exercisers increased aerobic exercise by 129 min/wk compared with 45 min/wk among usual care participants (p < .001). Women randomized to exercise experienced decreases in insulin, IGF-I, and IGFBP-3, whereas women randomized to usual care had increases in these hormones. Between-group differences in insulin, IGF-I and IGFBP-3 were 20.7% (p = 0.089), 8.9% (p = 0.026), and 7.9% (p = 0.006), respectively. Moderate-intensity aerobic exercise, such as brisk walking, decreases IGF-I and IGFBP-3. The exercise-induced decreases in IGFs may mediate the observed association between higher levels of physical activity and improved survival in women diagnosed with breast cancer.